术前单核细胞/淋巴细胞比值对Stanford A型主动脉夹层患者行小切口主动脉夹层术后低氧血症发生情况的预测  

Preoperative monocyte/lymphocyte ratio for type Stanford A aortic dissection prediction of the occurrence of hypoxemia after small-incision aortic dissection

作　　者：张晓慧 牛天羽 孙彪 卢宇川 徐子桐 姜辉 都业君 ZHANG Xiao-hui;NIU Tian-yu;SUN Biao;LU Yu-chuan;XU Zi-tong;JIANG Hui;DU Ye-jun(Department of Cardiovascular Surgery,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院心血管外科,辽宁沈阳110016 [2]大连医科大学研究生院,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2024年第6期331-335,共5页Trauma and Critical Care Medicine

摘　　要：目的探讨术前单核细胞/淋巴细胞比值(MLR)对急性Stanford A型主动脉夹层(ATAAD)患者行小切口主动脉夹层术后低氧血症发生情况的预测。方法选取2023年1月至12月北部战区总医院收治的65例经胸腹主动脉CTA确诊为ATAAD的患者,男性47例,女性18例,年龄(53.56±10.07)岁,年龄范围28~73岁。患者均行小切口主动脉夹层手术。评估患者低氧血症的发生情况,比较未发生低氧血症患者与发生低氧血症患者的术前基线资料、手术情况及术后情况。结果未发生低氧血症患者与发生低氧血症患者术前MLR水平及术中体外循环时间比较,差异有统计学意义(P<0.05)。多因素logistics回归分析显示,术前较高MLR水平是ATAAD患者行小切口主动脉夹层术后发生低氧血症的独立危险因素。受试者操作特征曲线结果显示,术前MLR对ATAAD患者行小切口主动脉夹层术后低氧血症的发生情况有一定的预测价值(曲线下面积0.734,截断值0.86,P<0.05)。结论术前高MLR水平是ATAAD患者行小切口主动脉夹层术后低氧血症发生情况的独立危险因素,术前MLR对ATAAD患者行小切口主动脉夹层术后发生低氧血症情况有一定的预测价值。Objective To explore the Preoperative monocyte/lymphocyte(MLR)ratio for acute type A aortic dissection(ATAAD)prediction of the occurrence of hypoxemia after small-incision aortic dissection.Methods A total of 65 patients who were diagnosed with ATAAD by thoracic and abdominal aortic CTA and treated in the General Hospital of the Northern Theater Command from January to December 2023 were selected,including 47 males and 18 females,with an age of(53.56±10.07)years old,ranging from 28 to 73 years.All patients underwent small incision aortic dissection surgery.The occurrence of hypoxemia in patients was assessed,and the preoperative baseline data,surgical conditions,and postoperative conditions of patients who did not develop hypoxemia were compared with those of patients who developed hypoxemia.Results Comparison of preoperative MLR levels and intraoperative cardiopulmonary bypass time between patients with hypoxemia and patients with no hypoxemia,the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that a higher preoperative MLR level was an independent risk factor for the development of hypoxemia after ATAAD patients undergoes small incision aortic dissection.The results of the receiver operating characteristic curve showed that preoperative MLR had a certain predictive value for the development of hypoxemia after ATAAD patients undergoes small incision aortic dissection(area under the curve 0.734,cutoff value 0.86,P<0.05).Conclusions A high preoperative MLR level is an independent risk factor for the development of postoperative hypoxemia after acute Stanford type A small incision aortic dissection,and preoperative MLR has a certain predictive value for the development of postoperative hypoxemia after acute Stanford type A small incision aortic dissection.

关 键 词：单核细胞/淋巴细胞比值 Stanford A 小切口 主动脉夹层 低氧血症 

分 类 号：R654[医药卫生—外科学]